Many children in the UK are identified as having a permanent hearing loss at birth through newborn hearing screening. Hearing children are rarely diagnosed with autism before age two. If a deaf child also has autism, this will often be diagnosed later. This is because some of the indicators of deafness are similar to those of autism.

These include:

a delay in acquiring language

appearing withdrawn

appearing indifferent to other people

preferring to play alone.

The delay in making a firm diagnosis of autism is because the professionals need to be sure that these behaviours are due to autism, not deafness.

Some parents find it helpful to track their child’s development to see if they’re developing as expected.

Parents can use the Early Support Monitoring Protocol to identify any potential concerns about their child’s development. These may include:

poor eye contact

not using common gestures such as waving

delay in pretend play

poor body awareness and balance: bumping into things, rocking, spinning or moving the whole body to look at something.

If you have any concerns, you should raise them with your GP, health visitor or Teacher of the Deaf, and ask for a referral for a possible diagnosis of autism.

A diagnosis of autism is usually carried out by a team of clinicians (for example: a child psychologist, speech and language therapist, a paediatrician). Ideally, it will be carried out by professionals who have expertise in both deafness and autism (but this isn’t always possible), alongside family and professionals who know the child best.

Research is currently underway to develop an assessment for autism in deaf children.

Communication can be complicated when it comes to children who are deaf and have autism.

It’s important to be open and supportive to your child and communicate in whatever way they can.

Whatever method of communication your child uses, it should be used consistently – both at home and in education.

Children with autism struggle with eye contact and joint attention (when parents naturally draw their child’s attention to something by, for example, looking at it themselves or using gestures) which can make the communication approaches often used by deaf children, such as lip-reading or sign language, more difficult.

Some families use non-verbal forms of communication, such as a Picture Exchange Communication System (PECS). A speech and language therapist may also be able to provide advice on the use of PECS and other non-verbal forms of communication.

Deaf children with autism can display challenging behavior. This can be due to frustration at not being able to express themselves due to delayed language, or because of a ‘meltdown’.

For children without language it can be difficult to know what’s causing challenging behavior, but it’s important to work with the child to try to find the cause so you can then act to reduce or remove it.

By being reflective, tracking and observing carefully it may be possible for parents and professionals to determine the cause of a meltdown, including if it’s the result of a particular sensory issue.

To do this, it can be helpful to think ‘ABC’:

A (antecedent, what happened before the meltdown)

What was the child doing?

Where was the child?

Who was with the child?

What was the environment?

Was there a possible sensory trigger? Light, sound, smell etc.

B (behaviour)

What is the child’s reaction/how do they behave?

How long did the behaviour last?

C (consequence)

What did you/other people present do?

What impact do your/their actions have/not have?

What happens next?

Using ABC, it should be possible to establish any patterns between meltdowns and specific triggers such as information or emotion overload, or sensory issues such as light levels, textures, sounds and smells.

As children mature and develop more language, they can share what they find stressful or frustrating, and begin to recognise how their body and feelings change in these situations.

This allows them to anticipate and think about how they can control their feelings and their response in the future.

Our resource What are you feeling? may be helpful in supporting your child to identify their emotions and talk about their feelings.

Many deaf children with autism will have an Education, Health and Care (EHC) plan (England), statement (Wales and Northern Ireland) or a coordinated support plan (Scotland). These are legal documents which set out your child’s special or additional needs, their school placement and the support that has been agreed. More information about this can be found on our website at Getting additional support in education.

As the number of deaf children with autism is small, it’s unlikely that there will be a school in your area with the specialist support your child needs already in place.

This means that it’s vital the different professionals supporting your child work together to make sure your child’s needs are being met and frequently reviewed.

For example, if a special school for children with autism is agreed to be the best placement for your child, it’s very important that they still get support from a Teacher of the Deaf and specialist speech and language therapist who can advise on hearing technology and communication needs.

It’s also important that the school your child goes to gives them the opportunity to use their preferred language and communication approach.

Some special schools for the deaf offer places to children with autism if they are able to meet their needs, for example, by supporting and developing the child’s social communication skills.